Sims: Even If Tanaka Gets Through Rehab, Surgery May Be Unavoidable
By Abby Sims
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Sidelined by a partial tear of the ulnar-collateral ligament in his right elbow, Masahiro Tanaka saw three specialists on Thursday and got a consensus of opinion as to a plan of care.
The good news is the doctors agreed that managing the injury rather than jumping right to surgery is the best course of action. That is clearly an indication that the tear is relatively small. However, though the course of treatment is conservative, the estimated amount of time for the player's potential return to action is anything but.
As I've written before, even with rest, PRP (platelet-rich plasma) injection and rehab, a torn ligament does not regain full tensile strength in a matter of weeks. And pitching -- especially at full velocity -– before it does so puts the already weakened tissue at further risk. Though we are all rooting for a successful outcome for the Yankees' young right-hander, saying that if he is able to return in six weeks he'll avoid surgery may be pushing it.
We've seen other pitchers attempt to rebound from UCL tears without undergoing Tommy John surgery. Few succeed. A very small tear -- if that is what it is -- improves Tanaka's chances of being one of the outliers. However, even if Tanaka makes it back before the end of this season, he will escape without treating the elbow more aggressively if it stands up to repeated stresses once he returns to the rotation. How he performs, not just initially but over time, would clearly be the key.
The six-week timetable for Tanaka's recovery that has been reported in the media may simply be in play to make the decision to opt for surgery more straightforward. If his condition hasn't sufficiently improved by then, there is always Plan B. Surgery clearly offers a more decisive outcome.
Dr. James Andrews' outlined his thoughts on the epidemic of Tommy John surgeries in a recent position paper, in which he also addressed the ways in which UCL injuries might be avoided. The cumulative effects of the demands of youth programs can only be modified for the pros of tomorrow. Going forward, Tanaka must be mindful that pitching without sufficient rest, when fatigued and at consistently high velocities increases risk. In addition, always pitching full out in bullpen and flat ground sessions may contribute to the vulnerability of the ligament.
So will hastening his return.
Follow Abby on Twitter at @abcsims
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